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Individual

DAVID SANJUAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
737 S SEMORAN BLVD, ORLANDO, FL 32807-3121
(321) 247-4960
(833) 963-0116
Mailing address
737 S SEMORAN BLVD, ORLANDO, FL 32807-3121
(321) 247-4960
(833) 963-0116

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
15442
PR
208D00000X
General Practice Physician
Primary
ACN1047
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100951000
FL
01
ACN1047
STATE LICENSE
FL
01
PV866
MEDICARE
FL
Enumeration date
08/25/2013
Last updated
03/07/2023
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